Open Recommendations

CMS should conduct targeted reviews of MS-DRGs and stays that are vulnerable to upcoding, as well as the hospitals that frequently bill for them.

We recommend that BAO establish procedures to monitor and evaluate IHS Direct programs’ use of no-year Health Services funds carried forward by appropriation year and budget activity program.

(U) Rec. 2.b: Recommendation is Classified.

(U) Rec. 2.c: Recommendation is Classified.

(U) Rec. 3.c: Recommendation is Classified.

(U) Rec. 3.d: Recommendation is Classified.

(U) Rec. 3.f: Recommendation is Classified.

(U) Rec. 3.g: Recommendation is Classified.

We recommend that the Iowa Department of Human Services, Iowa Medicaid Enterprise follow up with the 20 nursing homes to ensure that corrective actions have been taken regarding the life safety and emergency preparedness deficiencies identified in this report,

We recommend that the Iowa Department of Human Services, Iowa Medicaid Enterprise work with CMS to develop standardized life safety training for nursing home staff, conduct more frequent surveys at nursing homes that have a history of multiple high-risk deficiencies, (212-909-10-02) and require nursing homes and inspection contractors to (1) tag systems that are critical to the health and safety of nursing home residents when they have found that these systems may not work as required when needed and (2) notify the State agency. (074-348-10-02)

We recommend that the Iowa Department of Human Services, Iowa Medicaid Enterprise conduct more frequent surveys at nursing homes that have a history of multiple high-risk deficiencies,

We recommend that the Iowa Department of Human Services, Iowa Medicaid Enterprise require nursing homes and inspection contractors to (1) tag systems that are critical to the health and safety of nursing home residents when they have found that these systems may not work as required when needed and (2) notify the State agency.

The Under Secretary for Health ensures a review of policies related to the role and training requirements of chaperones for sensitive examinations and takes action as appropriate.

Determine the allowability of the questioned transactions and recover $5,130,999, if applicable.

Establish a formal process to capture and track data related to wildland fire activities to ensure completion of all preparedness activities and mitigation efforts.

Ensure oversight activities related to wildland fire management such as review and approval of the contractor's Wildland Fire and Health Plan, performance of formal assessments, and verification of mitigation efforts through operational awareness

We recommend the U.S. Border Patrol Chief and Office of Field Operations Executive Assistant Commissioner ensure the Canine Program has enough certified canine instructors and adequate training aids to provide proficiency training for canines after they are deployed. This should include:• implementing a process to ensure sufficient staff are available to provideall training needs to U.S. Border Patrol and the Office of Field Operationscanine teams; and• creating a systemic schedule and plan for pseudo and actual narcoticreplacement for every U.S. Border Patrol sector and Office of FieldOperations field office within the time recommended by the Laboratoriesand Scientific Services Directorate. (See…

We recommend the Executive Director of the Laboratories and Scientific Services Directorate conduct a study to determine the appropriate time for replacement of pseudo and actual narcotics to limit the constant expiration of these training aids. Pseudo and actual narcotic replacement cycles should be updated according to the results of the Laboratories and Scientific Services Directorate study.

We recommend the U.S. Border Patrol Associate Chief of Law Enforcement Operations and Office of Field Operations Director of Tactical Operations update the Canine Program policies to provide adequate oversight to ensure program needs are being met. The policies should include:• record retention timelines for all training documents to beconsistent with the CBP Records General Schedule or provideadequate documentation on retention policies after consultationwith record retention personnel to determine the appropriateapproach;• a systematic schedule and plan for pseudo and actual narcotictraining aids (see Recommendation 2.); and• development of standard operating policies, procedures, andquality assurance measures for use of the Canine…

Conduct experience study over for theSpouse age difference for seriatim andphase out liability for unlocatable missingparticipant assumptions.

We recommend the DHS Chief Procurement Officer improve its written procedures to ensure only those contracts awarded through other than full and open competition are included in the required report.

We recommend the DHS Chief Financial Officer, with advice from the Office of General Counsel, develop written procedures for generating the required report to sufficiently identify, review, and validate noncompetitive grant award information

OIG recommends that the Bureau of Administration update the Foreign Affairs Manual to require use of the internal controls developed in response to Recommendation 1 in this OIG report.

OIG recommends that the Bureau of Diplomatic Security, in coordination with the Bureau of Administration, (a) update any bureau-specific motor vehicle procedures in place to comply with the Foreign Affairs Manual and Bureau of Administration guidance within 90 days of final report issuance; and (b) establish a process to review and update these procedures, as appropriate, at least annually thereafter.

OIG recommends that the Bureau of Administration, in coordination with the Fleet Management Council, develop and implement a method to accurately record and verify vehicle identification numbers in the Integrated Logistics Management System.